Novel Technique for Subretinal Injection Using Local Removal of the Internal Limiting Membrane

Retina ◽  
2016 ◽  
Vol 36 (5) ◽  
pp. 1035-1038 ◽  
Author(s):  
Toshio Okanouchi ◽  
Shinji Toshima ◽  
Shuhei Kimura ◽  
Yuki Morizane ◽  
Fumio Shiraga
Keyword(s):  
Internal Limiting Membrane ◽  
Novel Technique ◽  
Subretinal Injection

scholarly journals Surgical treatment of «dry» forms of central chorioretinal dystrophy with the use of platelet-rich blood autoplasma

2017 ◽  
Vol 98 (3) ◽  
pp. 390-393
Author(s):  
D G Arsjutov
Keyword(s):  
Surgical Treatment ◽  
Pigment Epithelium ◽  
Vitreoretinal Surgery ◽  
Internal Limiting Membrane ◽  
Hyaline Membrane ◽  
The Impact ◽  
Observation Period ◽  
Subretinal Injection ◽  
Sodium Solution

Aim. To study the impact of platelet-rich blood autoplasma on the capability of the retinal regeneration in nonexudative forms of central chorioretinal dystrophy with the use of microinvasive vitreoretinal surgery. Methods. Surgical treatment was performed on 14 patients with central chorioretinal dystrophy aged 29 to 87 years. The surgery technique consisted of 3-port 25+, 27 Ga vitrectomy with posterior hyaline membrane and internal limiting membrane peel with subsequent central retinal exfoliation with 38 Ga cannula and balanced sodium solution and subretinal injection to the formed in macule space 0.1-0.2 ml of platelet-rich autolplasma. Results. As a result of the treatment according to this technique during the long-term period after the surgery (1 to 9 months) thickness of fovea reduced to 85-150 µm in average staying stable during the whole observation period. In 9 patients pigment epithelium thickened from 24 to 38 µm in parafoveolar area and fovea area. Corrected vision in 3 patients reached 0.1, and in the rest it did not exceed 0.06, herewith, all patients noted consistently improved vision. All patients had favorable evolution of photosensitivity according to microperimetry in average from 0.1-0.5 to 8.5-11 dB with a tendency of fixation point movement from periphery to the center. Conclusion. Vitreoretinal surgery 25+, 27 Ga for nonexudative forms of central chorioretinal dystrophy with the use of subretinal injection of platelet-rich autoplasma is a microinvasive, safe, effective method of the treatment of such pathology improving vision characteristics and anatomical and physiological characteristics of the eye involved.

Surgical Repair of a Persistent Full-Thickness Macular Fold With Base-to-Base Photoreceptor Apposition Secondary to Hypotony From Trabeculectomy Surgery and Postoperative Laser Suturelysis

2018 ◽  
Vol 2 (3) ◽  
pp. 179-182
Author(s):  
Douglas S. M. Iaboni ◽  
Mark E. Seamone ◽  
R. Rishi Gupta
Keyword(s):  
Visual Acuity ◽  
Internal Limiting Membrane ◽  
Active Management ◽  
Full Thickness ◽  
Management Options ◽  
Internal Limiting Membrane Peeling ◽  
Retinal Fold ◽  
Pars Plana ◽  
Retinal Folds ◽  
Subretinal Injection

Purpose: To report the successful repair of a persistent full-thickness retinal fold secondary to hypotony from trabeculectomy surgery. Results: Laser suturelysis was performed on a patient to relieve an elevated intraocular pressure posttrabeculectomy surgery. This resulted in chronic hypotony, a full-thickness retinal fold, and a decline in visual acuity to “count fingers.” The patient underwent a pars plana vitrectomy with internal limiting membrane peeling, subretinal injection of balanced saline solution, fluid-air exchange, injection of F-Decalin, peripheral retinotomy, endolaser photocoagulation, and vitreous substitution with 15% C3F8 gas. Anatomic improvement was documented via multimodal imaging. Six months postoperatively best-corrected visual acuity (BCVA) returned to 20/30. Conclusions: We describe a surgical approach to full-thickness retinal folds and review the management options previously reported in the setting of hypotony. We provide support for the active management of appositional full-thickness retinal folds involving the fovea and demonstrate that surgical correction can significantly improve BCVA even after 4 months of hypotony.

Viscostretch: A Novel Surgical Technique for Refractory Macular Holes

2020 ◽  
Vol 4 (3) ◽  
pp. 239-242
Author(s):  
Kyle D. Kovacs ◽  
Luis A. Gonzalez ◽  
Abdallah Mahrous ◽  
Donald J. D’Amico
Keyword(s):  
Surgical Technique ◽  
Internal Limiting Membrane ◽  
Fluid Exchange ◽  
Internal Limiting Membrane Peeling ◽  
Retinal Tissue ◽  
Novel Technique ◽  
Initial Surgery ◽  
Macular Holes ◽  
Pars Plana ◽  
Ophthalmic Viscosurgical Device

Purpose: We present a novel technique of subretinal viscodissection for addressing refractory macular holes (MHs). Methods: A case report and surgical technique description are provided. Results: In this technique, standard pars plana vitrectomy with internal limiting membrane peeling (unless previously peeled) is performed. A cohesive ophthalmic viscosurgical device (OVD) is injected through the MH, focally detaching the parafoveal retinal tissue around the hole. The OVD is removed at the conclusion of the air-fluid exchange. We provide an example of a recurrent 833-µm MH that was successfully closed despite failing initial surgery. There was no retention of subretinal OVD, and anatomic closure was achieved in this patient with a refractory MH. Conclusions: In refractory holes with adhesions at the MH base, this technique mobilizes the adjacent retinal tissue and uses the air’s surface tension to facilitate closure. Surgeons can consider using this technique as part of their MH arsenal.

scholarly journals Submacular Injection of Ranibizumab as a New Surgical Treatment for Refractory Diabetic Macular Edema

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Samir M. El-Baha ◽  
Ahmed M. Abdel Hadi ◽  
Mahmoud A. Abouhussein
Keyword(s):  
Surgical Technique ◽  
Macular Edema ◽  
Noncomparative Study ◽  
Ilm Peeling ◽  
Novel Technique ◽  
Refractory Diabetic Macular Edema ◽  
Pars Plana ◽  
The Mean ◽  
New Surgical Technique ◽  
Subretinal Injection

Purpose. In this study, we describe a new surgical technique for the treatment of refractory DME. The technique consists of vitrectomy with ILM peeling with a subretinal injection of ranibizumab. Methods. This is a prospective interventional noncomparative study including patients with refractory DME. Included patients were subjected to the new surgical technique of pars plana vitrectomy with subretinal injection of ranibizumab. Results. The study included 19 eyes with refractory macular edema, in which this novel technique was attempted. There were 10 males and 9 females. The age of the patients ranged from 17 to 67 years with a mean of 55.58 ± 13.242 years. The duration of diabetes before enrollment in the study ranged from 7 to 25 years with a mean of 16.3 years. Preoperatively, the mean CMT of the eyes ranged from 352 to 883 microns with mean ± SD of 498.58 ± 152.16 microns. Postoperatively, this improved significantly to 373.5 ± 100.3, 355.9 ± 89.8, and 365.74 ± 120.12 microns at 1, 3, and 6 months, respectively (p≤0.001 for all). Conclusion. This novel surgical procedure of vitrectomy with ILM peeling with a subretinal injection of ranibizumab is effective in cases of refractory DME. The study has been registered in Contact ClinicalTrials.gov PRS Identifier: NCT03975088.

scholarly journals Release and extraction of retained subfoveal perfluorocarbon liquid facilitated by subretinal BSS, vibration, and gravity: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kosuke Takahashi ◽  
Shuhei Kimura ◽  
Mio Morizane Hosokawa ◽  
Yusuke Shiode ◽  
Shinichiro Doi ◽  
...  
Keyword(s):  
Internal Limiting Membrane ◽  
Partial Recovery ◽  
Retinal Damage ◽  
Horizontal Position ◽  
Perfluorocarbon Liquid ◽  
Retinal Surface ◽  
Case Presentation ◽  
Infusion Pressure ◽  
Retinal Tears ◽  
Subretinal Injection

Abstract Background Perfluorocarbon liquid (PFCL) is an effective surgical adjuvant in performing vitrectomy for severe vitreoretinal pathologies such as proliferative vitreoretinopathy and giant retinal tears. However, subretinal retention of PFCL can occur postoperatively and retained PFCL causes severe visual disorders, particularly when PFCL was retained under the fovea. Although several procedures have been proposed for subfoveal PFCL removal, such as direct aspiration or submacular injection of balanced salt solution (BSS) to dislodge the subfoveal PFCL, the retinal damage associated with these procedures has been a major problem. Here, we report a case of subfoveal retention of PFCL for which we performed a novel surgical technique that attempts to minimize retinal damage. Case presentation A 69-year-old man presented with subfoveal retained PFCL after surgery for retinal detachment. To remove the retained PFCL, the internal limiting membrane overlying the subretinal injection site is first peeled to allow low-pressure (8 psi) transretinal BSS infusion, using a 41-gauge cannula, to slowly detach the macula. A small drainage retinotomy is created with the diathermy tip at the inferior position of the macular bleb, sized to be slightly wider than that of the PFCL droplet. The head of the bed is then raised, and the surgeon gently vibrates the patient’s head to release the PFCL droplet to allow it to migrate inferiorly towards the drainage retinotomy. The bed is returned to the horizontal position, and the PFCL, now on the retinal surface, can be aspirated. The subfoveal PFCL is removed while minimizing iatrogenic foveal and macular damage. One month after PFCL removal, the foveal structure showed partial recovery on optical coherence tomography, and BCVA improved to 20/40. Conclusion Creating a macular bleb with low infusion pressure and using vibrational forces and gravity to migrate the PFCL towards a retinotomy can be considered as a relatively atraumatic technique to remove subfoveal retained PFCL.

Sign in / Sign up

Export Citation Format

Share Document